It's official. Beta was 0. :(
The doctor's response to my questions:
1. Did the BCP and Lupron combo over-suppress my ovaries?
Stimulation was very acceptable. The only negative was that we did not have as many mature eggs as we would have liked. The lower number of mature eggs would not be influenced by the birth control pills or the Lupron.
2. Did not getting my period prior to baseline throw off dates and start me stimming too early?
No,, not at all. Your baseline blood test and ultrasound was perfect despite the early period
3. When my e2 levels weren't rising fast enough my follistim dose was raised. Was that dose too much too quick? After that raise my lead follicles took off. Should we have stimmed me at less of a dose for longer instead of such high a dose in a shorter amount of time?
In general, the optimum number of days of stimulation with this type of protocol is 8-12 days thus the length of your stimulation was quite typical.
4. Did the scenario from #3 impact my egg quality?
We do not generally know why some patients have a lower percentage of mature eggs. When we see this we typically do change the protocol the next time but very frankly there is no real scientific basis for these changes.
5. Was my lining too thick? At one of my monitoring sessions days before the egg retrieval my lining was already 13+mm. I can only imagine how thick it was at transfer.
Your lining was a little thicker than average but this is not a negative issue.
6. Was my c-section scar an issue? During the transfer the doctor had to "push" past it. I am not sure if that was the cause but I had cramps for days after transfer.
The C-section scar often does cause some resistance as the catheters is passed. However looking at the pictures of the transfer the placement of the embryos were just where we like them.
7. What is the reasoning behind a day 3 transfer?
As with most programs, we tend to transfer on day 3 unless we have about 8 8 cell embryos on day 3.
8. Was assisted hatching used on my embryos (or is that not something done on day 3 embryos?)?
Yes, assisted hatching was done as is our routine
9. Realistically, do you think my two frozen 9 and 12 cell embryos have any chance of success? Were they fragmented?
The 2 embryos that are frozen have less than 25% fragmentation which is certainly an acceptable amount.
10. Will they be transferred on day 3 or cultured to day 5?
.day 3
11. Will assisted hatching be performed on them?
Yes
12. When can I do the FET?
We generally have you. skip one cycle and then do the frozen transferred the following cycle
13. What would you change in a future fresh cycle?
- New protocol? Add menopur? Add ganirelix?
- No BCPs?
- Culture to day 5?
- Skip fresh transfer (my only success ever was on a FET)?
We can discuss the above if the frozen embryo transfer does not work. At this point I would probably not change the protocol much. I would probably use a combination of Follistim and Menopur but otherwise pretty much the same protocol
14. Are there any supplements I can start taking now to improve future egg quality?
- melatonin
- HGH
- DHEA
I have not been impressed with any of those. However certainly with DHEA there are no negatives to taking it.
1. Did the BCP and Lupron combo over-suppress my ovaries?
Stimulation was very acceptable. The only negative was that we did not have as many mature eggs as we would have liked. The lower number of mature eggs would not be influenced by the birth control pills or the Lupron.
2. Did not getting my period prior to baseline throw off dates and start me stimming too early?
No,, not at all. Your baseline blood test and ultrasound was perfect despite the early period
3. When my e2 levels weren't rising fast enough my follistim dose was raised. Was that dose too much too quick? After that raise my lead follicles took off. Should we have stimmed me at less of a dose for longer instead of such high a dose in a shorter amount of time?
In general, the optimum number of days of stimulation with this type of protocol is 8-12 days thus the length of your stimulation was quite typical.
4. Did the scenario from #3 impact my egg quality?
We do not generally know why some patients have a lower percentage of mature eggs. When we see this we typically do change the protocol the next time but very frankly there is no real scientific basis for these changes.
5. Was my lining too thick? At one of my monitoring sessions days before the egg retrieval my lining was already 13+mm. I can only imagine how thick it was at transfer.
Your lining was a little thicker than average but this is not a negative issue.
6. Was my c-section scar an issue? During the transfer the doctor had to "push" past it. I am not sure if that was the cause but I had cramps for days after transfer.
The C-section scar often does cause some resistance as the catheters is passed. However looking at the pictures of the transfer the placement of the embryos were just where we like them.
7. What is the reasoning behind a day 3 transfer?
As with most programs, we tend to transfer on day 3 unless we have about 8 8 cell embryos on day 3.
8. Was assisted hatching used on my embryos (or is that not something done on day 3 embryos?)?
Yes, assisted hatching was done as is our routine
9. Realistically, do you think my two frozen 9 and 12 cell embryos have any chance of success? Were they fragmented?
The 2 embryos that are frozen have less than 25% fragmentation which is certainly an acceptable amount.
10. Will they be transferred on day 3 or cultured to day 5?
.day 3
11. Will assisted hatching be performed on them?
Yes
12. When can I do the FET?
We generally have you. skip one cycle and then do the frozen transferred the following cycle
13. What would you change in a future fresh cycle?
- New protocol? Add menopur? Add ganirelix?
- No BCPs?
- Culture to day 5?
- Skip fresh transfer (my only success ever was on a FET)?
We can discuss the above if the frozen embryo transfer does not work. At this point I would probably not change the protocol much. I would probably use a combination of Follistim and Menopur but otherwise pretty much the same protocol
14. Are there any supplements I can start taking now to improve future egg quality?
- melatonin
- HGH
- DHEA
I have not been impressed with any of those. However certainly with DHEA there are no negatives to taking it.
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